The court, by a 5-4 vote, upheld the vast majority of President Barack Obama's health care overhaul, including the core requirement that virtually all Americans have health insurance.

The decision means the huge overhaul, still taking effect, will proceed and pick up momentum over the next several years, affecting the way that countless Americans receive and pay for their personal medical care.

"Just because a couple people on the Supreme Court declare something to be 'constitutional' does not make it so," said Sen. Rand Paul, R-Ky. "The whole thing remains unconstitutional. While the court may have erroneously come to the conclusion that the law is allowable, it certainly does nothing to make this mandate or government takeover of our health care right."

On CNBC, he called the decision, "bone-headed," adding: "Wait until you see the reaction from the Tea Party."

At the other end of the spectrum, House Minority Leader Nancy Pelosi, D-Calif., went to Twitter to declare "Victory for the American people! Millions of American families and children will have certainty of health care benefits + affordable care."

She was so thrilled by the ruling that she is throwing a party for select Democratic staffers on Capitol Hill, NBC News reported.

The ruling handed Obama a campaign-season victoryin rejecting arguments that Congress went too far in approving the plan. However, Republicans quickly indicated they will try to use the decision to rally their supporters against what they call "Obamacare."

House Speaker John Boehner, R-Ohio, said the law is hurting our economy by driving up health costs and making it harder for small businesses to hire.

"Today's ruling underscores the urgency of repealing this harmful law in its entirety," he said in a statement. "What Americans want is a common-sense, step-by-step approach to health care reform that will protect Americans' access to the care they need, from the doctor they choose, at a lower cost. Republicans stand ready to work with a president who will listen to the people and will not repeat the mistakes that gave our country ObamaCare."

Senate Majority Leader Harry Reid, D-Nev., said it's time now for Congress to move on to other business.

He said no one believes the law is perfect, but that Democrats have shown they'll work with Republicans to improve it. But he said GOP lawmakers are more interested in giving power back to insurance companies. He said passing the law is the single greatest step in generations to ensuring affordable health care for people in the United States.

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Florida's Sen. Marco Rubio, who has been mentioned as a possible running mate of GOP presidential hopeful Mitt Romney, said: "What's important to remember is that what the court rules on is whether something is constitutional or not, not whether it's a good idea. And while the court has said that the law is constitutional, it remains a bad idea for our economy, and I hope that in the fall we will have a majority here that will not just repeal this law, but replace it with real solutions that will insure more people and cost a lot less money."

Romney said he will work "on my first day as president" to repeal the law. Republican campaign strategists said Romney plans to attack the president's signature health-care program as a tax increase.

"Obama might have his law, but the GOP has a cause," said veteran campaign adviser Terry Holt. "This promises to galvanize Republican support around a repeal of what could well be called the largest tax increase in American history."

Democrats said Romney, who backed an individual health insurance mandate when he was Massachusetts governor, will have a hard time exploiting the ruling.

"Mitt Romney is the intellectual godfather of Obamacare," said Democratic consultant Jim Manley. "The bigger issue is the rising cost of health care, and this bill is designed to deal with it."

Obama said it's time to move forward.

"The highest court of the land has now spoken. We will continue to implement this law and we'll work together to improve on it where we can," he said at the White House.

"What we won't do — what the country can't afford to do — is re-fight the political battles of two years ago or go back to the way things were."

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